AB0711 The Impact of Anemia on Systemic Organ Damage in Systemic Sclerosis
Authors: Z. H. Li, T. Li, R. Mu
Journal: Annals of the Rheumatic Diseases (2022)

Background Systemic sclerosis (SSc) is a systemic autoimmune disease with multiple organ damage. Scleroderma Clinical Trials Consortium (SCTC) has developed the Damage Index (DI) in SSc to quantify organ damage in SSc [1] . Anemia has been implicated as an independent prognosis factor for mortality and organ complications in systemic sclerosis (SSc), while the relationship between anemia and the weighted organ damage index has not been reported. Objectives To determine the degree and feature of organ damage in SSc patients with or without anemia in a population of patients from Peking University Third Hospital SSc cohort (PKUTH-SSc). Methods Patients were recruited from PKUTH-SSc between January, 2010 and December, 2021. The diagnosis of anemia was based on the reduced hemoglobin (Hb) concentrations (&lt;120g/L for female and &lt;135g/L for male). The demographics, clinical characteristics, laboratory parameters, autoantibodies medication and SCTC-DI were collected. Student‘s t-test and Chi-square were used. Results As shown in Table 1, a total of 155 patients were enrolled in PKUTH-SSc cohort, 70 (45.2%) patients developed anemia, older and lower BMI than non-anemia patients. The inflammatory indices, ESR and CRP, were higher in anemia patients, indicating anemia was more common in patients with active disease. Consistent with the result that the positive rate of anti-SSA and anti-SSB antibody was higher in anemia patient, the sicca symptoms were also reported in nearly half of anemia patients. In anemia patients, the Gastrointestinal system related damage, Oesophageal dysmotility, Pseudo-obstruction and weight loss, and renal damage were more frequently discovered. Moreover, anemia patients were more likely to develop moderate to high organ damage risk, demonstrating the necessary of regular organ damage follow-up for anemia patients. Table 1. Clinical parameters and SCTC-DI of SSc patients with or without anemia AnemiaN=72 Non-anemiaN=83 p value Age at baseline (years) 54.43±1.88 49.64±1.32 0.034* BMI (kg/m2) (meanyear 20.49±0.40 22.46±0.39 &lt;0.001* ESR 32.48±3.06 16.67±1.83 &lt;0.001 CRP 1.20±0.22 0.64±0.11 0.014* Anti-SSA 22 (31.4%) 13 (15.3%) 0.017* Anti-SSB 8 (11.4%) 1 (1.2%) 0.018* Musculoskeletal and skin 2.22±.22u 1.11±.11u &lt;0.001* Sicca symptoms 31 (44.3%) 22 (25.9%) 0.016* Vascular 0.67±.67u 0.59±.59u 0.628 Gastrointestinal 2.09±.09r 1.31±.31r &lt;0.001* Oesophageal dysmotility 27 (38.6%) 18 (21.2%) 0.018* Pseudo-obstruction 5 (7.1%) 0 (0.0%) 0.017* BMI&lt;18.5 kg/m 2 or weight loss &gt;10% in the last 12 months 40 (57.1%) 31 (36.5%) 0.010* Respiratory 2.24±.24i 1.59±.59i 0.132 Cardiovascular 0.94±.94i 0.66±.66i 0.468 Renal 0.21±.21l 0.00±.00l 0.027* History of SRC 4 (5.7%) 0 (0.0%) 0.040* SCTC-DI 8.37±.37- 5.25±.25- &lt;0.001* Moderate to high damage score 48 (68.6%) 31 (36.5%) &lt;0.001* Conclusion Anemia is associated with distinct organ damage behaviors and higher disease progression risk in SSc. Specifically Sicca symptoms and gastrointestinal, renal system were more common in SSc patients with anemia. References [1]Ferdowsi N, Huq M, Stevens W, et al. Development and validation of the Scleroderma Clinical Trials Consortium Damage Index (SCTC-DI): a novel instrument to quantify organ damage in systemic sclerosis [published correction appears in Ann Rheum Dis. 2019 Aug;78(8):e88]. Ann Rheum Dis. 2019;78(6):807-816. doi:10.1136/annrheumdis-2018-214764 Disclosure of Interests None declared